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QI toolkit: driver diagrams

The Kings Fund describe a driver diagram as a “Visual model that highlights all the factors that influence the patient’s experience, to enable you to structure your thinking about how to affect the experience. It helps you to identify existing improvement initiatives that could influence the experience, and to select current and future priorities for action.”

An example produced by the East London Foundation Trust is below. The team developed an improvement strategy to achieve the aim of improving the inpatient experience for adult female inpatients on a mental health unit in order to increase satisfaction by 25% in 10 months.

driver diagram

Four steps for a successful driver diagram

  1. Set out what you want to achieve in your Aim. Make it specific and measurable. It should not simply be ‘to reduce’ or ‘to improve’. It should be meaningful to staff, patients, and families. A key benefit of a well-written Aim is that it can help you to identify your outcome Measure (see Section 3 – Model for Improvement).
  2. Identify the big topics and important areas that need to be addressed to achieve your aim in the Primary Drivers, such as Patient Choice. Well-written Primary Drivers help you identify your process measures, which review the reliability of processes that might have an impact on the aim of the project.
  3. Consider which activities can positively influence the Primary Drivers. In the case of Patient Choice it might be complaints or a ward round. These are Secondary Drivers, which can influence more than one Primary Driver and help you identify relevant Change Ideas.
  4. Think very carefully about your Change Ideas. They should have an effect on least one Secondary Driver and help achieve your aim. These are the important changes that will go into your
    project plan.

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